Black or African American
25%
Love, J., Kisker, E., Ross, C. M., Schochet, P. Z., Brooks-Gunn, J., Paulsell, D., et al. (2002). Making a difference in the lives of infants and toddlers and their families: The impacts of Early Head Start. Volumes I-III: Final technical report [and] appendixes [and] local contributions to understanding the programs and their impacts. Washington, DC: U.S. Department of Health and Human Services, Head Start Bureau.
Additional Source(s)
Love, J. M., Kisker, E. E., Ross, C., Raikes, H., Constantine, J., Boller, K., et al. (2005). The effectiveness of Early Head Start for 3-year-old children and their parents: Lessons for policy and programs. Developmental Psychology, 41(6), 885–901. doi:10.1037/0012-1649.41.6.885
View manuscriptRoggman, L. A., Boyce, L. K., Cook, G. A., & Hart, A. D. (2002). Making a difference in the lives of infants and toddlers and their families: The impacts of Early Head Start. Vol. 3, Local contributions to understanding the programs and their impacts. Washington, DC: Administration for Children and Families, Office of Planning, Research, and Evaluation, Child Outcomes Research and Evaluation.
View manuscriptRaikes, H. H., Chazan-Cohen, R., Love, J. M., & Brooks-Gunn, J. (2010). Early Head Start impacts at age 3 and a description of the age 5 follow-up study. In Childhood Programs and Practices in the First Decade of Life: A Human Capital Integration. Reynolds, A.A., Rolnick, A.J., Englund, M.M, and Temple, J.A., eds. New York: Cambridge University Press, 99-118.
View manuscriptScreening Conclusion
Eligible for review
Model(s) Reviewed
Funding Sources
Administration for Children and Families (ACF), the Child Outcomes Research and Evaluation team (CORE)within ACF’s Office of Planning, Research and Evaluation (OPRE), and the Head Start Bureau in the Administration on Children, Youth and Families (ACYF)
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Established on race/ethnicity and socioeconomic status; Established on many relevant outcomes |
None |
Not assessed in manuscripts reviewed under Handbook of Procedures and Standards, Version 1 |
Notes
In 2020, HomVEE updated this review to remove mother's partnership status/family structure findings from the Family Economic Self-Sufficiency domain because ACF determined that mother's partnership status is ineligible for review by HomVEE.
The study expressed some effect sizes as a percentage of the standard deviation. To be consistent with other studies, HomVEE divided the study-reported effect size by 100 and rounded to two decimal places.
This study received a mixed rating. Outcomes from the Parent Services Interview have low attrition and typically receive a high rating (though some outcomes that were assessable at baseline and not controlled receive a moderate rating). Outcomes from the Child Assessment (Bayley) and Parent/Child Interactions have high attrition, but baseline equivalence is established and those outcomes receive a moderate rating. Outcomes from the 36-month parent interview have high attrition, but baseline equivalence was established so they generally rate moderate, although outcomes on maternal health and male/father presence were assessable and not controlled, and therefore rate low.
Findings that rate moderate or high in this manuscript
Child Development and School Readiness
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| Bayley BRS: Orientation/Engagement | Age 3 | Moderate | 3.40 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Bayley Behavioral Rating Scale(BRS): Emotional regulation | Age 3 | Moderate | 2.10 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Bayley Mental DevelopmentIndex(MDI)Standard Score | Age 3 | Moderate | 9.50 | Not statistically significant, p ≥ 0.05 | 746 children | EHS-HBO impact study | ||
| Child behavior checklist - aggressive behavior | Age 3 | Moderate | 7.80 | Not statistically significant, p ≥ 0.05 | 746 children | EHS-HBO impact study | ||
| Engagement of parent during parent-child puzzle challenge task | Age 3 | Moderate | 5.60 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Engagement of parent during parent-child semistructured play | Age 3 | Moderate | 19.20 | Statistically significant,p < 0.05 | 744 children | EHS-HBO impact study | ||
| Frustration during parent-child puzzle challenge task | Age 3 | Moderate | 5.90 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Negativity toward parent during parent-child semistructured play | Age 3 | Moderate | 6.60 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Peabody Picture Vocabulary Test (PPVT)-III Standard Score | Age 3 | Moderate | 9.10 | Not statistically significant, p ≥ 0.05 | 746 children | EHS-HBO impact study | ||
| Percentage with PPVT-III | Age 3 | Moderate | 6.10 | Not statistically significant, p ≥ 0.05 | 746 children | EHS-HBO impact study | ||
| Percentage with MDI | Age 3 | Moderate | 3.10 | Not statistically significant, p ≥ 0.05 | 746 children | EHS-HBO impact study | ||
| Persistence during parent-child puzzle challenge task | Age 3 | Moderate | 12.00 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Sustained attention with objects during parent-child semistructured play | Age 3 | Moderate | 10.60 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study |
Child Health
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| Any child health services | 28 months after assignment | High | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | |||
| Any dentist visits | 28 months after assignment | High | 0.03 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Any doctor visits | 28 months after assignment | High | 0.16 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Any emergency room visits | 28 months after assignment | High | 0.06 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Any immunizations | 28 months after assignment | High | 0.31 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Any screening tests | 28 months after assignment | High | 0.04 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Child’s health status | Age 3 | Moderate | 0.04 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact sample | ||
| Percentage of children in fair or poor health | Age 3 | Moderate | 0.01 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact sample |
Family Economic Self-Sufficiency
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| Average hours per week employed | 28 months after assignment | High | 0.02 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Average hours per week in any employment, education, or training activity | 28 months after assignment | High | 0.09 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Average hours per week in education or training | 28 months after assignment | High | 0.24 | Statistically significant,p < 0.01 | 941 mothers | EHS-HBO impact study | ||
| Employed: 1st quarter | 28 months after assignment | High | 0.05 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employed: 2nd quarter | 28 months after assignment | High | 0.10 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employed: 3rd quarter | 28 months after assignment | High | 0.07 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employed: 4th quarter | 28 months after assignment | High | 0.00 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employed: 5th quarter | 28 months after assignment | High | 0.02 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employed: 6th quarter | 28 months after assignment | High | 0.07 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employed: 7th quarter | 28 months after assignment | High | 0.05 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employed: 8th quarter | 28 months after assignment | High | 0.08 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employment, education, or training: 1st quarter | 28 months after assignment | High | 0.02 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employment, education, or training: 2nd quarter | 28 months after assignment | High | 0.04 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employment, education, or training: 3rd quarter | 28 months after assignment | High | 0.01 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employment, education, or training: 4th quarter | 28 months after assignment | High | 0.08 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employment, education, or training: 5th quarter | 28 months after assignment | High | 0.04 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employment, education, or training: 6th quarter | 28 months after assignment | High | 0.14 | Statistically significant,p < 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employment, education, or training: 7th quarter | 28 months after assignment | High | 0.08 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Employment, education, or training: 8th quarter | 28 months after assignment | High | 0.03 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Ever employed | 28 months after assignment | High | 0.04 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Ever employed or in education/training | 28 months after assignment | High | 0.05 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Ever in ESL class | 28 months after assignment | Moderate | 0.07 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Ever in education or training | 28 months after assignment | High | 0.15 | Statistically significant,p < 0.05 | 941 mothers | EHS-HBO impact study | ||
| Ever in high school | 28 months after assignment | Moderate | 0.20 | Statistically significant,p < 0.01 | 941 mothers | EHS-HBO impact study | ||
| Ever in vocational program | 28 months after assignment | Moderate | 0.07 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Ever received AFDC or TANF | 28 months after assignment | High | 0.06 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Ever received food stamps | 28 months after assignment | High | 0.03 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Ever received welfare | 28 months after assignment | High | 0.05 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Have GED | 28 months after assignment | High | 0.09 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Have high school diploma | 28 months after assignment | High | 0.07 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| In education or training: 1st quarter | 28 months after assignment | High | 0.01 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| In education or training: 2nd quarter | 28 months after assignment | High | 0.05 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| In education or training: 3rd quarter | 28 months after assignment | High | 0.04 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| In education or training: 4th quarter | 28 months after assignment | High | 0.11 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| In education or training: 5th quarter | 28 months after assignment | High | 0.13 | Statistically significant,p < 0.05 | 941 mothers | EHS-HBO impact study | ||
| In education or training: 6th quarter | 28 months after assignment | High | 0.18 | Statistically significant,p < 0.01 | 941 mothers | EHS-HBO impact study | ||
| In education or training: 7th quarter | 28 months after assignment | High | 0.14 | Statistically significant,p < 0.05 | 941 mothers | EHS-HBO impact study | ||
| In education or training: 8th quarter | 28 months after assignment | High | 0.22 | Statistically significant,p < 0.01 | 941 mothers | EHS-HBO impact study | ||
| Income above poverty line, (percentage) | 28 months after assignment | High | 0.05 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Received AFDC or TANF: 1st quarter | 28 months after assignment | High | 0.06 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Received AFDC or TANF: 2nd quarter | 28 months after assignment | High | 0.01 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Received AFDC or TANF: 3rd quarter | 28 months after assignment | High | 0.05 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Received AFDC or TANF: 4th quarter | 28 months after assignment | High | 0.02 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Received AFDC or TANF: 5th quarter | 28 months after assignment | High | 0.04 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Received AFDC or TANF: 6th quarter | 28 months after assignment | High | 0.05 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Received AFDC or TANF: 7th quarter | 28 months after assignment | High | 0.11 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Received AFDC or TANF: 8th quarter | 28 months after assignment | High | 0.00 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Total AFDC or TANF benefits ($) | 28 months after assignment | High | 0.04 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Total food stamps benefits ($) | 28 months after assignment | High | 0.05 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Total welfare benefits ($) | 28 months after assignment | High | 0.02 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study |
Linkages and Referrals
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| Any education-related services | 28 months after assignment | Moderate | 1.13 | Statistically significant,p < 0.01 | 941 mothers | EHS-HBO impact study | ||
| Any employment-related services | 28 months after assignment | Moderate | 0.81 | Statistically significant,p < 0.01 | 941 mothers | EHS-HBO impact study | ||
| Any family health services | 28 months after assignment | High | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | |||
| Any family mental health services | 28 months after assignment | High | 0.10 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Housing assistance | 28 months after assignment | Moderate | 0.04 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Identification of child’s disability | 28 months after assignment | High | 0.05 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Services for child with disability | 28 months after assignment | High | 0.06 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study | ||
| Transportation assistance | 28 months after assignment | Moderate | 0.24 | Statistically significant,p < 0.01 | 941 mothers | EHS-HBO impact study |
Maternal Health
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| FES: Family conflict | 36 months postpartum | Moderate | 0.01 | Not statistically significant, p ≥ 0.05 | 950 mothers | EHS-HBO impact sample | ||
| PSI Parent-Child dysfunctional interaction | 36 months postpartum | Moderate | 0.10 | Not statistically significant, p ≥ 0.05 | 950 mothers | EHS-HBO impact sample | ||
| PSI Parental distress | 36 months postpartum | Moderate | 0.14 | Not statistically significant, p ≥ 0.05 | 950 mothers | EHS-HBO impact sample | ||
| Subsequent birth by 24 months after random assignment | 28 months after assignment | High | 0.07 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact sample |
Positive Parenting Practices
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| HOME harshness | Age 3 | Moderate | 0.06 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| HOME internal physical environment | Age 3 | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| HOME total score | Age 3 | Moderate | 0.04 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| HOME warmth | Age 3 | Moderate | 0.01 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| HOME: support of language and learning | Age 3 | Moderate | 0.07 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| Detachment during parent-child puzzle challenge tasks | Age 3 | Moderate | 0.04 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Detachment during parent-child semi-structured play | Age 3 | Moderate | 0.09 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Index of severity of discipline strategies | Age 3 | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| Intrusiveness during parent-child puzzle challenge task | Age 3 | Moderate | 0.09 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Intrusiveness during parent-child semistructured play | Age 3 | Moderate | 0.06 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Negative regard during parent-child semistructured play | Age 3 | Moderate | 0.10 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Parent-child play | Age 3 | Moderate | 0.06 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Percentage of children that follow a bedtime routine | Age 3 | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| Percentage of children with a regular bedtime | Age 3 | Moderate | 0.07 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| Percentage of parents suggesting physical punishment as a discipline strategy | Age 3 | Moderate | 0.01 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| Percentage of parents that read to child at bedtime | Age 3 | Moderate | 0.08 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| Percentage of parents that read to child daily | Age 3 | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| Percentage of parents that spanked child in the past week | Age 3 | Moderate | 0.11 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| Percentage of parents that usually use a car seat correctly | Age 3 | Moderate | 0.02 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| Percentage of parents that would use mild discipline only | Age 3 | Moderate | 0.00 | Not statistically significant, p ≥ 0.05 | 950 children | EHS-HBO impact study | ||
| Quality of assistance during parent-child puzzle challenge task | Age 3 | Moderate | 0.03 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Supportive presence during parent-child puzzle challenge task | Age 3 | Moderate | 0.07 | Not statistically significant, p ≥ 0.05 | 744 children | EHS-HBO impact study | ||
| Supportiveness during parent-child semistructured play | Age 3 | Moderate | 0.16 | Statistically significant,p < 0.05 | 744 children | EHS-HBO impact study |
Reductions In Child Maltreatment
| Outcome Measure | Timing of Follow-Up | Rating | Direction of Effect | Effect Size (Absolute Value) | Stastical Significance | Sample Size | Sample Description | |
|---|---|---|---|---|---|---|---|---|
| Number of emergency room visits for injuries | 28 months after assignment | High | 0.00 | Not statistically significant, p ≥ 0.05 | 941 mothers | EHS-HBO impact study |
This study included participants from the following locations:
- State not reported or international
Study Participants
This study relies on data from a randomized controlled trial of 17 Early Head Start (EHS) programs that began in 1995. Seven of the programs served clients through a home-based option (though other clients in other EHS options also received home visits) and are the focus of this report (EHS-HBO). The study randomly assigned 1,385 families, who applied to those 7 programs, either to receive home-based EHS or a comparison condition. This study included outcomes reported for the 3-year-old follow-up (other years of follow-up are reported in separate studies). For this follow-up, 950 parents (502 in EHS-HBO and 448 in the comparison group) provided data for parent interviews. Among parent interview participants, 46 percent were white, 25 percent were black, and 26 percent were Hispanic. One in four parents had more than a high school education, and one in 10 were in families living above the poverty line; one-third to one-half of families were receiving welfare (AFDC) or Food Stamps.
Setting
The study was conducted in 17 EHS programs throughout the United States, including 7 programs with home-based options, which are the focus of this report. Four programs were located in urban areas and three programs were located in rural areas. The seven programs represented a mix of implementation timing; one early implementer had all EHS-HBO elements in place by 1997, and three later implementers had all elements in place by 1999; three programs did not have all elements in place by 1999. The early-implementing program had fully implemented both child and family development services early and continued to have those services in place in 1999.
Intervention condition
Note: Navigate to the model page for more information about the home visiting model. See the source manuscript for more information about how the model was implemented in this study.
Comparison Conditions
Control group families could not receive EHS-HBO services, but could receive other services available in their community.